Coronavirus disease 2019 (COVID-19) antiviral response in a pan-tumor immune monitoring (CAPTURE) (NCT03226886) is a prospective cohort study of COVID-19 immunity in patients with cancer. Here we evaluated 585 patients following administration of two doses of BNT162b2 or AZD1222 vaccines, administered 12 weeks apart. Seroconversion rates after two doses were 85% and 59% in patients with solid and hematological malignancies, respectively. A lower proportion of patients had detectable titers of neutralizing antibodies (NAbT) against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants of concern (VOC) versus wild-type (WT) SARS-CoV-2. Patients with hematological malignancies were more likely to have undetectable NAbT and had lower median NAbT than those with solid cancers against both SARS-CoV-2 WT and VOC. By comparison with individuals without cancer, patients with hematological, but not solid, malignancies had reduced neutralizing antibody (NAb) responses. Seroconversion showed poor concordance with NAbT against VOC. Previous SARS-CoV-2 infection boosted the NAb response including against VOC, and anti-CD20 treatment was associated with undetectable NAbT. Vaccine-induced T cell responses were detected in 80% of patients and were comparable between vaccines or cancer types. Our results have implications for the management of patients with cancer during the ongoing COVID-19 pandemic.

BackgroundDengue remains an important cause of morbidity in Laos. Good knowledge, attitudes and practices (KAP) among the public regarding dengue prevention are required for the success of disease control. Very little is known about dengue KAP among the Lao general population.MethodsThis was a KAP household survey on dengue conducted in a peri-urban Pak-Ngum district of Vientiane capital, Laos. A two-stage cluster sampling method was used to select a sample of participants to represent the general community. Participants from 231 households were surveyed using an interviewer-administered questionnaire.ResultsAlthough 97% of the participants heard of dengue, there was a lack of depth of knowledge on dengue: 33% of them did not know that malaria and dengue were different diseases, 32% incorrectly believed that Aedes mosquito transmits malaria, 36% could not correctly report that Aedes mosquitoes bite most frequently at sunrise and sunset; and < 10% of them recognized that indoor water containers could be Aedes mosquito breeding sites. Attitude levels were moderately good with a high proportion (96%) of participants recognizing that dengue was a severe yet preventable disease. Self reported prevention methods were quite high yet observation of the participants’ yards showed use of prevention methods to be only moderate. The majority (93%) of the interviewees did not believe that they had enough information on dengue. There was an association between good knowledge and better practices, but good knowledge was associated with worse attitudes.ConclusionsThere is a lack of depth of knowledge regarding dengue in Pak-Ngum community and observation methods revealed that more needs to be done by community members themselves to prevent the spread of Aedes mosquitoes.

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Summary Alkylating chemotherapy is often used to treat pre‐menopausal women for various malignancies and autoimmune diseases. Chemotherapy‐associated ovarian failure is a potential consequence of this treatment which can cause infertility, and increases the risk of other long term adverse health sequelae. Randomised trials, predominantly of women undergoing alkylating chemotherapy for breast cancer, have shown evidence for the efficacy of gonadotropin‐releasing hormone agonists (GnRHa) in preventing chemotherapy‐associated ovarian failure. The European St Gallen and United States National Comprehensive Cancer Network guidelines recommend the use of concurrent GnRHa to reduce the risk of ovarian failure for pre‐menopausal women undergoing chemotherapy for breast cancer. The GnRHa goserelin, a monthly 3.6 mg depot subcutaneous injection, has recently been listed on the Australian Pharmaceutical Benefits Scheme to reduce risk of ovarian failure for pre‐menopausal women receiving alkylating therapies for malignancy or autoimmune disease. The first dose of goserelin should ideally be administered at least 1 week before commencement of alkylating treatment and continued 4‐weekly during chemotherapy. Concurrent goserelin use should now be considered for all pre‐menopausal women due to commence alkylating chemotherapy (except those with incurable cancer), regardless of their childbearing status, in an effort to preserve their ovarian function. For women who have not completed childbearing, consideration of other fertility preservation options, such as cryopreservation of embryos or oocytes, is also important.

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DiagnosisCT, PET/CT and MRI brain: Stage IVB (T2b N3 M1) NSCLC EBUS: TTF1-positive adenocarcinoma ALK/ROS1 IHC negative, PD-L1 IHC negative, EGFR wild type (COBAS v2) ctDNA (Guardant 360) NGS reported: TP53 T125T mutation Tissue sample sent for orthogonal NGS (FoundationOne) Commenced carboplatin and pemetrexed chemotherapy Notified that there was insufficient tissue for orthogonal genotyping Repeat EBUS for molecular analysis Pembrolizumab added to cycles 3 and 4 of carboplatin and pemetrexed CT response evaluation following cycle 4: Partial response Tissue NGS report: EGFR exon 20 insertion (A763_Y764insFQEA)

Unlike traditional chemotherapy agents which are generally cytotoxic to all cells, targeted anti-cancer therapies are designed to specifically target proliferation mechanisms in cancer cells but spare normal cells, resulting in high potency and reduced toxicity. There has therefore been a rapid increase in their development and use in clinical settings, including in curative-intent treatment regimens. However, the targets of some of these drugs including kinases, epigenetic regulatory proteins, DNA damage repair enzymes and proteasomes, have fundamental roles in governing normal ovarian physiology. Inhibiting their action could have significant consequences for ovarian function, with potentially long-lasting adverse effects which persist after cessation of treatment, but there is limited evidence of their effects on reproductive function. In this review, we will use literature that examines these pathways to infer the potential toxicity of targeted anti-cancer drugs on the ovary.

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